Musculoskeletal manifestations in hemodialysis patients are numerous and frequent, being more prevalent in those undergoing long duration dialytic treatment. Arthralgia is the most commom symptom, occurring in more than 70% of patients. Secondary hyperparathyroidism is the main cause of bone renal disease, and clinical manifestations are bone pain, arthralgia and pruritus. Amyloidosis, due to b2-microglobulin deposition in tissues, manifests as shoulder pain, carpal tunnel syndrome, trigger finger, spontaneous tendon rupture and pathological fractures. Other musculoskeletal manifestations observed are crystal-induced arthritis, avascular necrosis, septic arthritis, muscle weakness and muscle cramps.